Dentistry - fractures, deciduous, resorption

Question 1

What are tooth fractures classified based on?

Answer 1

Fracture location
Pulp exposure

Question 2

What are the different types of fracture affecting the enamel?

Answer 2

Enamel infraction - cracking
Enamel fracture - loss of enamel on the crown (chip)

Question 3

What types of crown fracture can you get in teeth?

Answer 3

Uncomplicated crown fracture - no pulp exposure
Complicated - fracture that exposes the pulp

Question 4

What are the different types of fracture involving the root?

Answer 4

Uncomplicated crown-root fracture (no pulp exposure)
Complicated crown-root fracture
Root fracture

Question 5

How can you tell if the pulp is exposed?

Answer 5

PInk/red if recent
Grey/black if chronic
Use a sharp explorer - will stick in
Radiography

Question 6

What are the signs of a fractured tooth on radiograph?

Answer 6

Peri-apical lucency - local infection at root
Root resorption
PDL widening

Question 7

How do you treat an enamel fracture or uncomplicated crown fracture?

Answer 7

Dont need to treat
Smooth sharp edges
Monitor

Question 8

How do you treat an uncomplicated crown-root fracture?

Answer 8

Dont need to treat, but close monitoring, careful home care

Question 9

How do you treat a complicated crown/crown-root/root fracture?

Answer 9

Extraction
(root canal at referral)
Analgesia

Question 10

What are the complications of fractured teeth?

Answer 10

Chronic pain
Toth root abscesses - swolled face, discharging tract

Question 11

What is tooth abrasion?

Answer 11

Wearing down teeth by rubbing tooth against an object
eg. tennis ball

Question 12

What is tooth attrition?

Answer 12

Wear from tooth on tooth contact due to malocculsion

Question 13

What does the body do to counteract abrasion/attrition?

Answer 13

Produce tertiary dentine - brown, discoloured reparative dentine

Question 14

What can cause a discoloured tooth?

Answer 14

Blunt trauma - purple from bleeding into dental tubules, pulpitis

Question 15

What are the two consequences of a blunt trauma to the tooth?

Answer 15

Pulpitis subsides, tooth survives
Tooth dies due to disrupted blood supply, goes grey/brown

Question 16

What should you do if there is a discoloured tooth?

Answer 16

Take radiographs, but likely to need extraction - irreversible trauma

Question 17

What is the appearance of deciduous teeth?

Answer 17

Smaller
Sharper
Proportionally longer roots
Whiter - enamel less mineralised

Question 18

How many deciduous teeth do dogs have?

Answer 18

28

Question 19

How many deciduous teeth do cats have?

Answer 19

26

Question 20

How are deciduous teeth lost?

Answer 20

Exfoliation by root resorption

Question 21

What are the indications for extraction of deciduous teeth?

Answer 21

Retained/persistant - 6 months onwards (do at neuter)
Fractured
Malocclusion

Question 22

What can malocclusion of deciduous teeth cause?

Answer 22

Pain
Restriction of normal jaw growth - shortened mandible

Question 23

What is tooth resorption?

Answer 23

Loss of dental hard tissue, exposing the soft tissue underneath - pink area on tooth

Question 24

What other names are there for tooth resorption?

Answer 24

Neck lesions
Feline odontoclastic resorptive lesions (FORLs)

Question 25

What species is tooth resorption common in?

Answer 25

Cats

Question 26

What is the aetiology of internal tooth resorption thought to be?

Answer 26

Start inside the tooth in endodontic system - due to pulpitis

Question 27

What is type one external tooth resorption?

Answer 27

Response to inflammation - periodontitis

Question 28

What is type two external tooth resorption?

Answer 28

Idiopathic

Question 29

How is tooth resorption classified?

Answer 29

On severity - stages On radiographic appearance - types

Question 30

What is type 1 tooth resorption?

Answer 30

Damage to tooth with radiolucency But normal looking root 'Inflammatory resorption'

Question 31

What is type 2 tooth resorption?

Answer 31

Radiolucency to tooth Loss of root clarity PDL space disappearing 'Replacement resorption'

Question 32

What is type 3 tooth resorption?

Answer 32

Features of both type 1 and 2 tooth resorption eg. one normal root, one resorbed

Question 33

How many mature cats have tooth resorption?

Answer 33

20-75%

Question 34

When is tooth resorption though to become painful?

Answer 34

When resorption communicates with oral cavity - dentine exposed

Question 35

How is tooth resorption diagnosed?

Answer 35

Tactile exploration Dental radiographs - essential

Question 36

Which teeth are most commonly affected by tooth resorption?

Answer 36

3rd mandibular premolars (307/407)

Question 37

What is the treatment for type 1 tooth resorption?

Answer 37

Extraction

Question 38

What is the treatment for type 2 tooth resorption?

Answer 38

Root replaced by bone - extraction can be difficult/contraindicated Can do crown amputation

Question 39

When do you do a crown amputation?

Answer 39

When confirmed type 2 tooth resorption on radiograph

Question 40

How do you do a crown amputation?

Answer 40

Create gingival flap Remove tooth down 1-2mm below bone level with bur Suture gingiva closed

Question 41

How should you treat type 3 tooth resorption?

Answer 41

Amputate type 2 root Extract type 1 root

Question 42

What is feline chronic gingivostomatitis?

Answer 42

Inappropriate inflammatory response of the oral mucosa in cats - very painful

Question 43

How do you diagnose feline chronic gingivostomatitis?

Answer 43

Clinical presentation Widespread lesions Caudal stomatitis - palatoglossal folds involvement (good prognostic indicator)

Question 44

What causes feline chronic gingivostomatitis?

Answer 44

Multifactorial Viruses, bacteria Plaque Immune system

Question 45

What viruses can contribute to feline chronic gingivostomatitis?

Answer 45

Calicivirus FIV/FeLV FHV

Question 46

How do you treat feline chronic gingivostomatitis medically?

Answer 46

Antibiotics - suppress, limited effect, will relapse Glucocorticoids - short course Immunomodulation - ciclosporin NSAIDs

Question 47

How do you treat feline chronic gingivostomatitis surgically?

Answer 47

Remove all disease teeth Clean Extract all teeth - worst cases

Question 48

What is the prognosis from surgical therapy of feline chronic gingivostomatitis?

Answer 48

1/3 resolve 1/3 improve but persists 1/3 need long term medical management

Question 49

What is a feline eosinophilic granuloma complex?

Answer 49

Granuloma/ulcer in the oral cavity, on tongue, lip, chin, palate Wax and wane

Question 50

How do you treat feline eosinophilic granuloma complex?

Answer 50

Immunosuppressive therapy to treat flare ups

Question 51

What is the most common oral/maxillofacial tumour in cats?

Answer 51

Squamous cell carcinoma